The combined movements of flexion or extension with lateral flexion and rotation of the trunk affect the range of motion of the spine. This fact may be used in theory of manual therapy, and one of the determinants for the most useful therapeutic technique selected for individual treatments. The purposes of this study are to measure tracing the rotational ROM of the spine with three direction motion analysis, and to identify the cause of change in ROM. Forty male subjects participated in the test, and they were thirty healthy persons and ten more or less impaired patients with spinal dysfunction. By attaching the markers on the 1^st 5^th and 9^th spinous process of the thoracic vertebrae, and on the 1^st and 5^th spinous process of the lumbar vertebrae for all the subjects, we traced and evaluated the rotatory movements of spinous process of both thoracic and lumbar vertebrae from the position of trunk flexion or extension with right lateral flexion. As a result, different ROMs appeared on each spinal column segment in separate positions. In addition, we figured out the complicated moving mechanism on the joint planes as well, which affect rotation, in ROMs when the spine is changed from flexion to extension. A significant difference in ROMs on certain positions was also found between the healthy and the patient groups.

View full abstract

The activity of the internal and external rotator muscle was observed using MRI in two positions, so to speak 1^st and 2^nd positions, to know the effective muscle strengthening exercise method.
Subjects were nine healthy males. Internal and external rotation exercise were performed, and their load was estimated as 50% of the maximum muscle strength. MRI was carried out before and immediately after each exercise. Subscapularis and infraspinatus muscles were identified, and ROI was picked out in each muscle. T2 value was calculated from the value of ROI, and the ratio of increase after each exercise to face in the resting period was obtained and compared.
T2 values in internal rotator muscles in the 1^st position were greater than those in the 2^nd position after internal rotation exercise. However T2 values in external rotator muscle showed no significant differences between two positions.
The results of present study suggested that the 1^st position may be effective for the internal and external rotator muscle strengthening exercise. It was the same results as the previous study using fine wire electromyogram.
MRI is considered useful to evaluate the muscle activity non-invasively, and to know the effective muscle exercise method in physical therapy.

View full abstract

The purposes of this study were to observe the change in general temperature distribution by ultrasound by following time using phantom and thermograph, and to examine changes in the temperature distribution when the metals of different sizes and the bone were inserted in the phantom. The temperature distribution without objects inserted was the same as those in the previous studies, and was able to be visually reconfirmed, which suggest the validity of this method. When the metal was inserted, not only aspect of reflection and interference but also aspect of the diffraction could be observed by thermograph, and in ultrasound application to the position where the metal was inserted, the necessity of considering the size of the implant, frequency, distance, and convergence rate was indicated. The temperature distribution when the bone was inserted showed a clear difference from that when the metal was inserted, which implies the necessity of further examination.

View full abstract

In this research, an evaluation equipment (toe grasp power measuring equipment and toe motor function measuring equipment) which quantitatively measured the toe function was developed. It measured twice by having changed time into the same subjects (n = 27), and the reproducibility of measurement apparatus was examined. Next, the relevance to toe function and physical performance ability for grasping power, knee extension muscle strength, 10 m walking time, center of foot pressure in static standing, and dynamic balancing when unstable board was used was examined for older people (n = 168). 168 persons were divided into the fallers and non-fallers groups from the medical history in the past, and comparison examination of toe grasp power and toe motor function was carried out. In addition, in order to examine the effectiveness of toe motion training for preventing falls, comparison examination of the effect was performed between the training group (n = 23) and the control group (n = 15). The training group trained 8 weeks using the toe functional training equipment. Results were as follows.
1:The measuring equipment showed the reliability and high reproducibility for measuring toe grasp power and toe motor function, and could objectively evaluate the toe function.
2:In the fallers group, the toe grasp force was significantly inferior than the non-fallers group.
3:A toe grasp force exerted a correlation with grasping power, toe motor function, knee extension muscle strength, dynamic balance, and the 10 m walking time. A toe motor function showed a correlation with grasp force, toe grasp force, dynamic balancing, knee extension muscle force, and the 10 m wa1king time.
4:In the training group, there was an improvement in dynamic balance and the knee extension muscle strength.
From the above results, toe function is important from the viewpoints of a physical performance and a fall. It was also suggested that a toe function training may be simple and effective for preventing falls.

View full abstract

The aim of this study was to examine the difference of time course of changes in exercise tolerance before and after open-heart cardiac surgery between elderly(E) and younger patients(C). Thirty five patients (male/female=24/11) with valvular heart disease who underwent cardiac surgery were divided into 2 groups according to age (group E;≧65 years, n=15, group C;<65 years, n=20). Serial changes in peak oxygen uptake (peak VO₂), an aerobic threshold (AT VO₂), respiratory function (vital capacity; VC, forced expired volume in 1 second; FEV_1.0), and muscle strength of leg were evaluated in all patients, while the original cardiac rehabilitation program including aerobic exercise was performed in all patients. In group E, all parameters were significantly lower than group C before surgery (peak VO₂; 16.7 ± 3.7 vs. 20.5 ± 5.5 ml/min/kg, AT VO₂; 11.0 ± 2.3 vs. 12.6 ± 5.5 ml/min/kg. VC; 2.9 ± 1.0 vs. 4.1 ± 0.8 L, FEV_1.0; 2.0 ± 0.6 vs. 3.3 ± 0.7 L. muscle strength; 199.5 ± 58.8 vs. 272.2 ± 78.3 N, p<0.05, respectively). Peak VO₂ and AT VO₂ were decreased in the early phase of after surgery (7 days after) in both groups, but only in group C, these parameters recovered to the baseline in the chronic phase of after surgery (21 days after). VC and FEV_1.0 were also transiently decreased after surgery and recovered in both groups. Strength of leg muscle was decreased transiently in group C, but recovered at discharge, and that of group E did not recover at discharge. These data suggest that decrease in lower limb muscle strength after surgery may be an important factor to limit the physical activity in group E. Accordingly, it may be reasonable to perform exercise training (including muscle training) particularly in elderly patients after cardiac surgery.

View full abstract

The purpose of this study was to investigate whether the change in the duration of standing on one leg from babyhood to school age children was linear or non-linear. Two hundred and thirty one healthy children aged from 18 months to 128 months participated in this study as subjects.
The time for standing on one leg was measured for the index of the equilibrium ability with the eyes open and closed. The relationship between the length of time standing on one leg and age was analyzed by the fit of a linear function, quadratic function, exponential function and logistic function style, and analyzed by the correlation coefficients.
As a result, the correlation coefficients of the quadratic function, exponential function and logistic function style with the eyes open and closed were higher than that of the linear function. In particular, the exponential and logistic function style compared with the linear function style demonstrated significantly higher coefficients. It was estimated that the fitting of the logistic style was increased with the eyes open when the range of subject's age was expanded to adults.
This study indicated that the change in the standing time on one leg of children was non-linear.

View full abstract

The purpose of this study was to determine the test-retest reliability of StrengthErgo240 (SE240: Mitsubishi Electric Corporation, Tokyo) which was a newly developed pedaling type Isokinetic device.
Nine (18 legs) healthy male volunteers with no history of bone and joint injury were enrolled in this study. Isokinetic test for peak leg extension torque and joule was performed by pedaling at 60 and 80 revolution per minute. Test data were analysed using the intracrass correlation coefficient (ICC) for two parameters in each speed.
High test-retest correlation coefficients were obtained (ICC>0.91 〜 0.98) at each speed and in two parameters. Thus information of isokinetic leg extension strength obtained by SE240 appeared to be quite reliable in a test retest situation.
Our results suggest that SE240 provides reliable data and can be applied as the strength measurement device for patients on rehabilitation treatment.

View full abstract

The aim of this study was to quantify the manual load of physical therapists (PTs) applied in the passive range of motion (ROM) exercise for knee. Using a knee reaction measuring device we developed, we measured the load torque on the knee and the knee flexion ROM during the passive knee flexion exercise, and reviewed the resulting load torque-time curve, knee flexion ROM-time curve, and load torque-knee flexion ROM curve. Also measured were the degree of pain and stiffness of the knee during flexion as felt by the PT. The subjects were 45 patients with ROM limit of the knee. The load torque, load torque-time curve, knee flexion ROM-time curve, and load torque-knee flexion ROM curve showed similar transitions with time regardless of the patient and PT. Factors affecting the load torque included the maximum knee flexion ROM, stiffness of joint as felt by the PT, pain scale, and days that have passed since the start of exercise. The maximum load torque was 16.5 Nm at the start of measurement, and 57.4 Nm at the completion of exercise by which the whole range of motion was acquired. The quantification of these load torque values suggests the possibility of developing a new ROM exercise device with the passive ROM exercise techniques of PTs.

View full abstract

The purpose of this study was to assess the intermachine correlation between newly developed pedaling type isokinetic machine (StrengthErgo β System; SE-β, Mitsubishi Electric Corporation, Tokyo) and the isokinetic dynamometer (BIODEX 2AP; BIODEX, New York). Ten healthy active females (20 legs) aged 22-29 years old with no history of bone and joint injury were enrolled in this study. Isokinetic test for peak leg extension torque was performed by pedaling at 60 and 80 cadence per minute (cpm) for 5 repetitions using SE-β. The exercise position was set at sitting and backrest was set at 110 degrees to the floor. To accustom to isokinetic pedaling in a sitting position, the subjects were ordered to pedal at 60 cpm for 5 minutes at 30 watts prior to the test. The isokinetic test for knee extension torque was performed at 60, 180 and 300 deg/sec using BIODEX 2AP. Pearson's correlation coefficient was applied to compare derived values between SE-β and BIODEX 2AP. Peak torque values in peak leg extension torque by SE-β at 60 and 80 cpm were 2.43 ± 0.38 and 2.03 ± 0.40 Nm/kg, respectively. Peak knee extension torque by BIODEX 2AP at 60, 180 and 300 deg/sec were 2.23 ± 0.33, 1.55 ± 0.24 and 1.19 ± 0.20 Nm/kg, respectively. The highest value of correlation coefficient was obtained between SE-β at 80 rpm and BIODEX 2AP at 60 deg/sec (r = 0.896, p < 0.001), and the lowest was obtained between SE-β at 60 cpm and BIODEX 2AP at 300 deg/sec (r = 0.753, p < 0.001). In conclusion, peak leg extension torque obtained by SE-β is reliable and SE-β can be applied for assessment of leg extension torque in rehabilitation patients who are unsuitable for measuring by conventional isokinetic machine.

View full abstract

We devised a Modified RIE-strap (MR), reformed conventional RIE-strap with the plastic duramen, as an Ankle-Foot-Orthosis (AFO) for hemiplegic patients. The effects of MR on the flexion-introduction and extension-suppression of the knees were evaluated in hemiplegic patients with locking or snapping when walking barefeet. It was confirmed that MR could introduce the forward flexion of the knee at the initial stance phase and could suppress the percussive extension of the knee at the middle to late stance phase, although the results did not amount to those of the shoehorn type AFO. Additionally, the outside appearance and the put-on feeling of MR are nice, and also we can use our shoes as it is.
From the above results and merits, it was implicated that MR would be a brace satisfying the needs of disabled persons.

View full abstract

This study was conducted in order to examine the buffering effects of coping strategies on the relationship between disability-related stressor and psychological status of stroke people in community. The subjects were 117 survivors after stroke (71 males and 46 females), who had adequate cognitive functions and lived in their community. We constructed a path model including functional status, coping (control, escape), depressed mood, and psychological well-being, based on Lazarus' cognitively oriented theory of psychological stress and coping. The model was evaluated by covariance structure analysis. As a result, the model fitted well to the data. The functional status was associated with depressed mood negatively, while the control coping strategy was associated with decreased depressed mood. Attempts were continued to examine the buffering effect of control coping, using analysis of covariance. The functional status and control coping had significant interactions between depressed mood. These results indicated that control coping strategies have a buffering effect between disability-related stressor and psychological status among stroke people in community.

View full abstract